The BIG Picture

Re-engineering primary healthcare system through

Health & Wellness Centers (HWCs)
 RMNCHA+N

Communicable Diseases

Non Communicable Diseases

Preventive and Promotive

Comprehensive
Primary Health Care –
Oral, Mental, Geriatric etc.

Secondary and Tertiary

Healthcare
a Platform to integrate service delivery
Ayushman Bharat – Health and Wellness Centres

Coverage
Moving towards
Universal Health
 Ayushman Bharat: Universal Health Coverage
• PMJAY empanelled Public &
TERTIARY Private Healthcare facilities
• CHCs/SDHs/District
Hospitals/Medical Colleges
SECONDARY

Gatekeeping
Referral/Return

PRIMARY Preventive, Promotive, Curative,

Rehabilitative & Palliative Care
CPHC
through Existing
Unmet needs:
AB-HWCs NCDs/other Chronic services:
Diseases RMNCH+A

CONTINUUM OF CARE – AB - HWCs (CPHC) & PMJAY

3
 Roll out Plan of Health and Wellness Centers

1.5 Lakh
160000

140000 APPROVALS > 60,000

1.1 Lakh 40000

120000
25,000 as on
100000 October 2019 70,000 40000 40000

80000
ACHIEVEMENT 17149 40,000
30000 30000 30000
60000

40000
25000 25000 25000 25000

20000
15000 15000 15000 15000 15000

0
2018-19 2019-20 2020-21 2021-22 Dec, 2022

Uttar Pradesh has 2119 functional HWCs (as on 19.08.2019) against the target of 5278 (FY 2019-20) 4
 Current Status – HWCs Operationalization in Uttar Pradesh

HWC Operationalization SCs PHCs UPHCs Total

Total Facilities in the state 20573 2727 592 23892

Total approved facilities till FY 2019- 7329 1786 405 9520

20
No. of HWCs operational till date 1241 941 394 2583

As per conditionality of HWC operationalization 25% of total facilities i.e.

5973 HWCs have to be functional by FY 2019-20 (March 2020)

Gap = 5973-2583= 3390

Time in hand= 4 months (Dec 2019 - March 2020)
Focus areas for next three months

6
 State level priorities
• First things first – Finalize list of facilities to be upgraded to HWCs in FY 2019 – 20/
FY 2020 – 21
• Protect your kitty – Compliance to RoP conditionality for HWCs (+20% or -20%)
 State to convert a total of 25% of SCs, PHCs & UPHCs to HWCs
 NCD screening- 15% of total population aged 30 years and above to be screened
 NCD application entries – Mandate to enter at least 50% of screened population in NCD
app

• B’coz money matters – Disbursement of funds to districts and HWCs

• Go for maximum – Prioritize your efforts as per the categorization of easy, moderate
and high efforts HWCs
• Ask for it – TA for preparation of PIP for FY 2020-21
• Don’t miss out on (include in PIP FY 2020-21):
 Cost of certificate course training of CHOs @ 1.03 lakhs per candidate
 Infrastructural strengthening cost of additional PSCs @ 2.5 lakhs per PSC
 IT equipment for additional HWCs @ 70000 per SC, 60000 for rural PHC & 1 lakh for UPHC
 Smart phones for ASHAs
 Untied funds for HWCs
 Incentives for yoga trainers
 IEC activities – if not included earlier
 Telemedicine
 Strengthening diagnostics- Salaries of LTs and funds for auto analysers
 Drugs
 Trainings- Induction training of CHOs, NCD training, Multiskilling training

8
• B’coz we have to do it right – Making HWCs fully operational as per the
functionality criteria
 Posting of HR (CHOs/ FLHWs/ MOs & other staff as per IPHS norms)
 Ensuring availability of drugs, supplies & equipment – expedite procurement
 Ensuring availability of Diagnostic tests (14 for SCs and 63 for PHCs)
 NCD training of all cadres of staff
 Population enumeration & CBAC form filling
 Initiation of NCD screening & management services
 Expediting entries of screened population NCD app
 Additional services beyond RMNCH+A and NCD
 Streamlining and Rolling out Performance Linked Payments
 Improving Daily and Monthly reporting from HWCs
 Regularizing indenting at HWCs using the DVDMS log in IDs
 Work with district officials to expedite printing and display of IEC materials
9
• It’s high time – Work towards rolling out fixed day services
 Yoga sessions – Identify space, yoga trainers, develop schedule and inform the community
 Teleconsultation sessions – Identify and connect with higher level facilities/ specialists,
develop a schedule & display at facilities
 Special day clinics
 Identify the type of relevant wellness activity based upon local context, locally acceptable and
appropriate cultural practices and beliefs and available resources
 Develop a Wellness Calendar

10
Classification of Functionality Criteria for prioritization of efforts

Easily doable/ Low Achievable With Requires

hanging fruits some Efforts considerable effort
• Training of HR • Drugs • Human Resource
• Universal • Diagnostics at PHC • IT systems –
screening of NCDs HWCs procurement
• Diagnostics at SC- • Infrastructure & • IT application
HWCs Branding (entry into app by
• NCD app training • Community ANM)
• Wellness activities Outreach

Identify and prioritize health facilities into these categories for targeted efforts
Focus on easy and moderate efforts facilities
 Analysis as per Functionality Status - Indicative
35

30 29 29 29 29 29 29 29 29
28
25
25
21
20

15
11
10 10 10
10

0
0
Human Training Community Universal Medicines Diagnostics IT system Infrastructure
Resource Outreach Screening of
NCD

Target PHC
 Strategy to adopt

Classification of
Selection of
criteria into Prioritization of
achievable criteria on
achievable and facilities based on
which performance is
achievable with these criteria
poor
efforts

Preparation of week
Achievement of at least
wise plan for
80% target facilities for
operationalization of
FY 2019-20 by March
facilities before 30th
2020
November, 2019
ETHOS FOR TEAM HWCs
• Build brand Jhpiego
 Become indispensable as lead technical partners for HWCs
 Strengthen your relationship with govt counterparts
 Make them perceive the need
 High quality and relevant TA
 Do not ever compromise on QUALITY

• Have a clear ASK

 Persistent advocacy efforts – No short cuts please!
 Find the corridor of least inertia

• Great things never come out of comfort zones – SO HANG ON

 Demonstrate what we bring to the table – Value addition
 Partnership not policing- Collaborative TA
 Persistence – Follow up and close the loop, do not leave threads open
15
• Create Noise
 We have to find a way that people know we are there – VISIBILITY MATTTERS !
 TWEET TWEET TWEET - Create hashtags/ campaigns to share our work
 Ensure creating twitter handles and extensive use of social media

• Document - Because if it was not written down, it did not happen

 Before after pictures
 Success stories, Beneficiary testimonials, Stories of change or transformation
 Champion CHOs/ providers/ FLHWs
 Suggest new communication ideas/ products

• Market yourself
 Believe in the beauty of your work- We have a chance to create HISTORY!
 Ensure uptake of new program products – IEC materials, facility & PSC branding package etc.
 Show and tell about your work where it matters
16
• B’coz its your responsibility too!
 Responsiveness – Because for everything the deadline was yesterday
 Fast track implementation– We are racing against time
 Sense of Ownership & Engagement – Its more than our JOB!
 Innovate to differentiate – New ideas/ processes
 Possible collaborations

• Protect our house

 TEAM spirit – Watch each others back
 Respect JHPIEGO culture – Ensure adherence to all organizational polices & norms
 Integrity is everything – Financial, programmatic, data – No fudging, no lies please
 World is watching you- Flawless work ethic
 It’s not business as usual – Efficient operations and effective planning
 Miles to go before we sleep – No room for complacency !
17
We are not here to be AVERAGE,
We are here to be AWESOME !!

18